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Xie X, Zhou L, Zhang X, Zou H, Lu Y, Xiao H. Evaluation of a knowledge-attitude-practice model based narrative life education program for community-dwelling older adults: a mixed-methods feasibility study. BMC Geriatr 2024; 24:547. [PMID: 38914955 PMCID: PMC11194897 DOI: 10.1186/s12877-024-05153-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2024] [Accepted: 06/17/2024] [Indexed: 06/26/2024] Open
Abstract
BACKGROUND The global aging population presents challenges that are particularly acute in China. Older Chinese adults' attitudes towards death significantly impact their quality of life. Death education is crucial for promoting positive perspectives on life and death. Narrative education offers a promising approach to facilitating death education. Integrating the Knowledge-Attitude-Practice (KAP) model into death education will enhance the feasibility and acceptability of death education programs. METHODS This mixed-methods feasibility study included a quasi-experimental trial and semi-structured interviews. Older adults in the intervention group (N = 27) received a 6-week KAP-based narrative life education program in addition to standard community health education; participants in the control group (N = 20) received only the normal community health education. In both groups, attitudes toward death and the meaning of life were assessed at baseline and immediately after the intervention. A post-intervention semi-structured interview and satisfaction survey were also conducted for the intervention group. RESULTS Forty out of 47 older adults completed the program for an 85.1% retention rate. All of the older adults in the experiment were very satisfied and satisfied with the life education program, and no adverse events were reported. Compared to the control group, participants in the intervention group had a significant decrease in the fear of death (P = 0.028), and substantial improvement in their value of life (P = 0.031), goal of life (P = 0.035), freedom of life (P = 0.003), and the total score for purpose in life (P = 0.017). The qualitative results yielded four themes: profound recognition of life and death, contradiction between thoughts and action, conflict between one's acceptance and others' avoidance, and evaluation of the life education program. CONCLUSIONS The KAP-based narrative life education program is feasible and acceptable for older Chinese community-dwelling adults. It is also potentially effective in improving attitudes toward death attitudes and the meaning of life in this cohort. TRIAL REGISTRATION This study was retrospectively registered at China Clinical Trial Registry as ChiCTR2300069551 on 2023-03-20. URL of registration: https://www.chictr.org.cn/showproj.html?proj=183176 .
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Affiliation(s)
- Xifeng Xie
- School of Nursing, Fujian Medical University, Fuzhou City, Fujian Province, China
| | - Li Zhou
- Nanjie Community Health Service Center, Fuzhou City, Fujian Province, China
| | - Xiaoling Zhang
- School of Nursing, Fujian Medical University, Fuzhou City, Fujian Province, China
| | - Huina Zou
- School of Nursing, Fujian Medical University, Fuzhou City, Fujian Province, China
| | - Yuanfeng Lu
- School of Nursing, Fujian Medical University, Fuzhou City, Fujian Province, China.
| | - Huimin Xiao
- School of Nursing, Fujian Medical University, Fuzhou City, Fujian Province, China.
- Research Center for Nursing Humanity, Fujian Medical University, Fuzhou City, Fujian Province, China.
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Zhang X, Xie X, Xiao H. Effects of death education interventions on cancer patients in palliative care: A systematic review and meta-analysis. DEATH STUDIES 2024; 48:427-441. [PMID: 37432171 DOI: 10.1080/07481187.2023.2233450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/12/2023]
Abstract
This review summarizes the best available evidence on the effects of death education in palliative care for cancer patients. A systematic literature review was conducted across 9 databases, revealing 22 eligible studies (N = 2,374). After two reviewers independently engaged in study selection, quality assessment, and data extraction, the results were synthesized through qualitative and quantitative analysis. Overall, the focus on death education for cancer patients showed an upward trend and consistently demonstrated significant positive effects with regards to the control of anxiety and depression, attitudes toward death, and quality of life. However, high-quality evidence regarding the effects of death education on cancer patients is lacking, warranting additional well-designed rigorous studies and standardized programs with specific and feasible steps.
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Affiliation(s)
- Xiaoling Zhang
- School of Nursing, Fujian Medical University, Fuzhou, China
- School of Nursing, Quanzhou Medical College, Quanzhou, China
| | - Xifeng Xie
- School of Nursing, Fujian Medical University, Fuzhou, China
| | - Huimin Xiao
- School of Nursing, Fujian Medical University, Fuzhou, China
- Research Center for Nursing Humanity, Fujian Medical University, Fuzhou, China
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Guo J, Xu X, Liu C, Wang Y, Chen Y. Perspectives of telemedicine-based services among family caregivers of patients with end-of-life cancer: a qualitative study in mainland China. BMC Palliat Care 2024; 23:16. [PMID: 38212798 PMCID: PMC10785499 DOI: 10.1186/s12904-024-01347-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 01/08/2024] [Indexed: 01/13/2024] Open
Abstract
BACKGROUND Despite being driven by a strong sense of duty and familial obligation, providing care for patients nearing the end of life poses challenges for family caregivers. Telemedicine has rapidly gained traction as a transformative approach to healthcare delivery, offering an array of benefits that could be particularly valuable in end-of-life care. However, research on the perspectives of telemedicine-based services among family caregivers of patients with end-of-life cancer is limited. Therefore, this study aims to explore the perspectives and preferences of telemedicine-based services among family caregivers of patients with end-of-life cancer and provide a framework for developing and executing a tailored telemedicine-based end-of-life care program that addresses the unique needs of family caregivers in mainland China. METHOD A descriptive phenomenological approach was used. Family caregivers were selected using purposive sampling at a tertiary cancer hospital. One-on-one semi-structured interviews were conducted with the participants from November to December 2022. Colaizz's method was used to analyze the interviews. RESULTS Fourteen participants participated in interviews. Three themes and ten subthemes were identified: motivation to receive telemedicine services (relief from the burden of home care; access to professional health care services), supportive care needs for telemedicine services (support for symptom management; negative emotional adjustment; death education; daily life care guidance), and functional expectations of telemedicine service platforms (ease of use; real-time online guidance and response; personalized automatic reminder; targeted matching push of health knowledge). CONCLUSION Family caregivers expressed interest in telemedicine-based services and identified various care needs before receiving telemedicine services. The findings of this study can help policymakers and healthcare providers develop more effective and culturally appropriate telemedicine-based service programs that can better support family caregivers of end-of-life cancer patients.
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Affiliation(s)
- Junchen Guo
- Department of Palliative Care, Hunan Cancer Hospital, No.283, Tongzipo Road, Yuelu District, Changsha, 410006, Hunan, China
- School of Nursing, University of South China, No.28, Changsheng West Road, Hengyang, 421001, Hunan, China
| | - Xianghua Xu
- Department of Palliative Care, Hunan Cancer Hospital, No.283, Tongzipo Road, Yuelu District, Changsha, 410006, Hunan, China
| | - Chaoyi Liu
- Department of Palliative Care, Hunan Cancer Hospital, No.283, Tongzipo Road, Yuelu District, Changsha, 410006, Hunan, China
| | - Ying Wang
- Department of Palliative Care, Hunan Cancer Hospital, No.283, Tongzipo Road, Yuelu District, Changsha, 410006, Hunan, China
| | - Yongyi Chen
- Department of Palliative Care, Hunan Cancer Hospital, No.283, Tongzipo Road, Yuelu District, Changsha, 410006, Hunan, China.
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Wu B, Zhu P, Wang T, Tan JYB, Cao Z, Wan J, Wu S, Zhang L, Xing Y. Experiences of Chinese advanced cancer patients after attending a "four-stage" death education programme: A qualitative study. Eur J Oncol Nurs 2023; 66:102361. [PMID: 37499403 DOI: 10.1016/j.ejon.2023.102361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Revised: 05/14/2023] [Accepted: 06/05/2023] [Indexed: 07/29/2023]
Abstract
PURPOSE This study aimed to explore the experiences of cancer patients who participated in and completed a "four-stage" death education programme based on knowledge-attitude-practice theory. METHODS This study employed a qualitative descriptive design. Semistructured interviews with an interview guide were used to collect data. Fifteen cancer patients who participated in and completed the "four-stage" death education programme (from November 10, 2021, to December 29, 2021) were recruited via purposive sampling. The "four-stage" death education programme model was developed based on knowledge-attitude-practice theory and included eight death education modules. Each interview was audio-recorded and transcribed verbatim. Generic analysis was used to conduct data analysis by coding, classifying, and extracting themes. RESULTS Five themes were identified: the gradual shift of death cognition towards objective reality, a decrease in death anxiety, patients' early thoughts concerning issues related to death and preparation ahead of death, patients' improved ability to respond to death incidents, and patients' increased focus on cherishing the remainder of their lives and living in the moment. CONCLUSIONS Cancer patients accept and respond effectively to the implementation of a "four-stage" death education programme based on knowledge-attitude-practice theory. These findings can help cancer patients improve their reasonable perception of death and reduce their doubts and confusion concerning death.
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Affiliation(s)
- Bing Wu
- Department of Nursing, Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, The Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, 210009, China
| | - Ping Zhu
- Department of Nursing, Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, The Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, 210009, China
| | - Tao Wang
- College of Nursing and Midwifery, Charles Darwin University, Darwin, Northern Territory, Australia
| | - Jing-Yu Benjamin Tan
- College of Nursing and Midwifery, Charles Darwin University, Darwin, Northern Territory, Australia
| | - Zhenglan Cao
- Department of Oncology Surgery, Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, The Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, China
| | - Jing Wan
- Department of Nursing, Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, The Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, 210009, China
| | - Suya Wu
- Department of Nursing, Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, The Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, 210009, China
| | - Liuliu Zhang
- Department of Nursing, Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, The Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, 210009, China.
| | - Yihui Xing
- Department of Internal Medicine-Oncology, Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, The Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, China.
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Kızılkaya M, Atuğ M. Views of Family Members Who Take Care of an Elderly Person they Live with on Ageism, Spirituality and Death in Turkey: A Qualitative Approach. JOURNAL OF RELIGION AND HEALTH 2023; 62:3095-3109. [PMID: 37266900 DOI: 10.1007/s10943-023-01837-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/11/2023] [Indexed: 06/03/2023]
Abstract
This descriptive qualitative research examined the views of people caring for an elderly family member on ageism, spirituality, and death. A total of 12 people who lived in the same house as the elderly person they cared for made up the study sample. Data were collected via face-to-face, in-depth interviews using a structured interview format. The content analysis method was used for the data analysis. The analysis of the study data yielded three themes: the definition of ageism, the meaning of spirituality and its effects on care, and the position of death in life. The results indicated that living with and caring for an elderly individual made the lives of the family members providing care meaningful, spirituality was important in the care of elderly individuals, and caregivers could be considered at risk in terms of the burden of care. It is recommended that health professionals support caregivers sharing the same house with an elderly family member through training programs on the burden of care, spiritual care, and death.
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Affiliation(s)
- Mehtap Kızılkaya
- Department of Mental Health and Diseases Nursing, Faculty of Nursing, Aydın Adnan Menderes University, Aydın, Turkey.
| | - Mahsun Atuğ
- Aydın Adnan Menderes University Research and Application Hospital, Aydın, Turkey
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